This form collects personal information about you so we can consider your claim and update your insurances. It will be held by Exclusive Insurance Services and the underwriter who handles your claim. You may request access to, and correction of, this information subject to the provisions of the Privacy Act 1993. The collection of this information by Exclusive Insurance Services is required under the terms of your insurance policy. Failure to provide this information may result in your claim being declined.
The section below relates to any other third party property or vehicles. Please complete if applicable.
Please do not admit liability to the third party as this may prejudice your claim. If the third party is insured they must approach their own insurer to lodge a claim. If you receive any correspondence from the Third Party please send it through to the claims team.
Established in 2006, Exclusive Insurance Services have worked hard to build a trusted and reliable reputation offering innovative and affordable risk management and insurance solutions to our extensive and rapidly growing client base.
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Level 2, 63 Albert Street,
Auckland 1010 New Zealand
P: +64 9 307 1295
M: +64 21 493 816
F: +64 9 307 6795